Telling sexual partners about HIV status

Telling partners when you are in a relationship

Many people find it hard to tell a partner about their HIV status. While some people do react badly to news that their partner is HIV positive, others offer support. The views expressed here are of gay and Black African communities that we interviewed in 2005.

A retired gay male who was diagnosed with HIV in 1989. His partner died of AIDS in the early 90s. He went through a 'mid-life crisis' more recently.

And I thought long and hard about this because I was finding that I had had situations where people were acting in a strange way when I told them that I was HIV positive. And they didn't know their own status, and I thought well this' you know here I am taking the time-out, not only do I know my own status, I am also looking after myself and the other person, and they don't even know their status. And yet you tell them, they don't know their status, and they turn around and act as if you know they want to put rubber gloves on immediately, and yet they can be doing what ever to you.

I would always tell now. Because for my head I now don't care if the other person reacts in a way because they don't know their status, as far as I am concerned, they are an idiot anyway. Because if they are going to treat me in a specific way and they don't know their own status, then I don't want to waste my time with them anyway really you know, it is just pointless. So my philosophy is to tell people that you are HIV and I you know' because I don't want to be' I don't even want to have sex with that person if they don't want to know, then I don't want to know either.

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Profile Info

Age at interview:

34

Sex:

Male

Age at diagnosis:

33

Background:

A 34 year-old black African man who came to the UK two years ago. He became ill and was admitted to hospital with TB, where he was diagnosed with HIV.

I have got a girlfriend here. I told her my situation. Showed her my letter of diagnosis… and then she said ah, there's nothing I can do… you have to use the condoms. So there's no problem for me, cos she accepted, I didn't force her to have intercourse without letting her know, plus… condom was actually… as I said earlier, I just feel it's better to tell someone.

If we go separate ways… we go separate ways. I cannot force her cos what I have is not what she has… As I say, that she accepted, and because… is using a condom, she accepted cos she just feel no, what's the purpose of disclosing my status when we are using condoms?

And normally I use about three condoms. I put on three condoms. I just put them for the, just for the sake of safety, so that… I'm just showing that I just care, I don't want to infect her… Just want her to live as long as… maybe if she doesn't have the disease she may live longer…

She was my lover from, since, I mean back home from when we had… during our school days. So we're going out together.

* Footnote' experts believe that using more than one condom could increase the chances of condoms breaking.

There is not always enough trust and openness in relationships for people to feel they can tell their partner: 'I had to sort of worm it (his HIV status) out of him initially,' said one man about his partner. When people do try to tell sexual partners about their HIV status, many fear rejection: 'That was incredibly hard when I started dating him, because I had to tell him,' said one person. 'I would tell them on the second… or if I was a coward, the third date,' said another. Many people said they need to find the right time to tell a partner, while ensuring that they have safe sex in the meantime.

Others, particularly those within African communities where HIV is greatly feared, felt they had to find ways to have safe sex rather than tell their partners. But this can be difficult. As one African woman said' 'You have to hide the medication. It's a bit stressing.' Some people tried to educate their partners about HIV so that they could tell them in time.

A highly educated health professional working full time. He is a black African man married with children.

One guy who has got, he is positive and he's got a partner who he's not sure whether she's positive or negative. And when he come to see me he said, 'OK do you use protection when... having sex?' I said, 'Yes.'

And he said well because, because actually when he came over here, he came from Africa and then he was diagnosed here.

Now when the, the girl joined him, the first thing which came on the agenda was the condom. Now they... they were not using condom in Africa. So he was sharing with me he said, 'Well, what, what reason did you give for you for using condoms?' I said, well, I was saying that, 'You know we have to be careful otherwise you'll be pregnant.' And then the problem is he's got difficulty to, to convince her to go for a test.

But he, he, he has consulted that he'll go for a one quick test at the [support organisation]... so, just to convince. But when we organised a [social support group], which he came with her, he said, 'Well I haven't disclosed to her, but when I came more, you know it's, it made it easier that I'm getting at ease to… one day to discuss it with her.' And that's how it works, yeah.

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Profile Info

Age at interview:

43

Sex:

Female

Age at diagnosis:

39

Background:

A 43 year old woman who came to the UK from Africa 4 years ago to study, but became very ill and was diagnosed with HIV.

You know our African men most of the times if you tell him that you are HIV positive, he will say, 'Oh so the whole of my life I am going to use the condom!'

So I am telling my partner that I'm using the condom with you every time because you know I am on, on this long treatment of TB medication, I can't have direct sex with you, we will have to use a condom. If I use, if we don't do, we don't do sex using the condom, you will be affected with this TB and he is understanding.

But if I tell him that I'm HIV positive, he will run away from me. Because he is thinking that in future, when I am cleared from this TB medication we will be doing direct sex. He doesn't know that it's for life. This person, she is HIV positive.

A few people - particularly the women - felt fearful when they revealed their HIV status to partners: 'You don't know whether they will turn it against you.' And even when people do tell, their partners may not believe they actually have HIV. And partners may not believe that they themselves could be positive: 'African men they don't believe that… they will just say no. When they are working and fit they just think they are well.'

A 33 year old black African female with a young 5 year old child. She was diagnosed as HIV positive as part of pregnancy screening.

When I was diagnosed an ex-boyfriend then, I told him, he said he was going to kill me, it was quite bad actually. I'm laughing now, it's not funny. But he actually said to me he was going to kill me if the test… if he goes on and has a test done and it comes positive, that is what he said. And he was really quite…

It wasn't nasty, but it was quite intimidating and threatening. I knew for him that was where…. how it was the way, it was shocking to him, and that's the way he could deal with, but of course it's wrong you know, at the end of the day. So he went and tested and he came back negative, and it was only after that he was now feeling… tried to be a bit supportive and all of that. But that turned me off, you know the way he reacted and all that.

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Profile Info

Age at interview:

37

Sex:

Female

Age at diagnosis:

26

Background:

She was diagnosed as HIV positive in 1994 when she got tested after a secretary at her work back in Africa became ill with HIV.

So he was really very serious, but I knew I was positive, I couldn't tell him at that time. I said we must test. He said no I am OK. I said we must. So I took him to a clinic, he did the test and I said I would not do it, you do yours, because mine I had already done it, I know what it is. You do yours. He accepted and and we collected the results, we went out with a colleague for lunch and I put it down. I said I am positive and you are negative. He denied it saying, 'You are not.' Some people find it hard to believe, like me, if you see me now, you wouldn't think I am.

Telling new and casual partners

People also had different views about telling new or casual partners about their HIV. Many felt they did not have to tell new or casual partners their HIV status provided they had safe sex: 'If I pick up somebody for casual sex I don't tell them I'm HIV positive. But I mean I practice safe sex with them.' Some others felt the same way, but they recognised risk could never be completely eliminated: 'I wouldn't tell them. Then I wouldn't put them at risk either… obviously there is some risk [with safe sex].'

A retired GP living with his partner of 9 years in London. He was diagnosed in 1990 after unprotected sex at a time when he assumed he was HIV positive.

First of all I think you have to have safe sex, secondly I think it's not one person's responsibility. And I would never, I mean if anybody asked me I'd say immediately, yes. So people are free to ask and everybody should have safe sex if they're concerned, either... Getting it or giving it. Even so it worries me a bit and I'm beginning to move towards the idea that you should at least provide, I should at least provide people with the opportunity to find out.

I'm just concerned about people being appalled if they find out subsequently. And I don't feel that if I've been involved sexually with somebody then I can be' that I'm the right person to be a counsellor, to explain to them what the risks are and so on. I mean they'll see me as... special pleading and all of that sort of thing, so I'd rather they did that first really. I mean I can give other people help and advice about other, their other partners still. I mean I'm always happy to talk to people about HIV and it's problems and complications. But I don't think I can tell, easily talk to somebody I'm intimately involved with about it. Because I'm not the right person to do it in that situation.

Some people were very clear that sex is not one-sided, so each partner had a responsibility to avoid HIV transmission: 'People say that it is my duty to tell them. No, it's their duty to treat their own body with respect. And to treat everybody as if they are positive [and always have safe sex].' Another man said 'it is a shared responsibility.' In practice, many people said they took on much of the responsibility to protect their partners.

We were told that people who reacted badly to being told about HIV sometimes were not even sure that they were HIV negative. One man had said to some partners: 'I know my antibody status, do you know yours?' Another said, 'I don't even want to have sex with that person if they don't want to know [about their status], then I don't want to know them either.'

Others found it difficult to have casual sex and keep their HIV secret. Some people worried about the risk involved, even for safe sex. For instance, one man said he could not have sex with casual partners because 'I might pass it on to them.' Others said they would rather find HIV positive partners.

Living in a city outside of London he was diagnosed with HIV in mid-2002. He developed tuberculosis shortly after diagnosis.

If, if I go out to a gay bar or' I mean [pause] it won't particularly bother me if someone makes an advance and I reject it. It doesn't bother me. Because I always said to myself in the back of my mind that I would not want to pass this thing on to anyone [pause] under any circumstances. And that was going back to when I got it. Because putting two and two together, you know, didn't have to be a Sherlock Holmes, it's someone that I went with who knew that they had it, but, you know, could have told me. But maybe didn't because they, they felt as if they'd be rejected if they did. You know. Now I am experiencing the same thing.

The only, the case is' The only difference here is that if I, if I do ever go with anyone, it will probably more likely be someone who is also HIV positive. Because I wouldn't want to run the risk.

My, my conscience wouldn't allow me to do anything like that. You know.

Still others were prepared to be upfront with new partners about their HIV. Some people said they would always tell a new partner of their HIV status because if that person was the right person for them, they would be OK with it. Others wanted to challenge ignorance by being upfront, or just get HIV out of the way before they had sex. But some people said that telling partners is always emotionally difficult: 'If I am going to sleep with somebody then they need to know I have HIV, and that leaves you automatically open and vulnerable.'

Many feared rejection if they told partners about their HIV: 'Sometimes it's easier to become celibate,' said one man. But such fears are not always justified. Some people who had fears were not rejected by their partners' HIV clearly did not put off some people.

On the other hand, most people who had told partners had been rejected at one time or another because of their HIV. People felt there was still ignorance and fear about HIV even in the community most informed about HIV: the gay community. One man said: 'There's still the odd people who are gay that say “we don't do it with positive people.” And I want to say, "How do you know that"?'; '[Some gay] people still think HIV is a terminal condition… If you have any form of sex you'll put yourself at risk.'

A 48 year old gay man who lives in a small village in the UK. He was diagnosed in 1986.

I did a little experiment, I went into, to one of the [gay] clubs and I'm going back about 2 years, after [my partner]'s death. Went into a club and got chatting to people and I would purposely tell them' I did it four times in one particular evening and told them I was HIV positive. And every time they talked to me very nicely, made an excuse and it ended. Which told me a hell of a lot' right. That just because I was being upfront and honest about my HIV, I was being discriminated against. They didn't want anything to do with me, and that's from my own sub group, in the sense, being the gay community. We're supposed to be probably more educated around HIV than the general population, because of what we went through in the 80s'

Telling people about your HIV status is not easy, it is very, very difficult. Your biggest fear is that you want to be accepted but your biggest' you're going to be rejected and it hurts.

But rejection because of HIV could be indirect. For instance, a few people thought that potential partners found ways not to go through with sex' 'The conversation ends and they walk off, or they excuse themselves very politely,' said one man. And people thought people could be fearful of having sex with someone with HIV, even if they did not admit it at the time.

A gay man born in the Caribbean who immigrated to the UK. He presumes he was infected in a relationship after not always using condoms consistently.

My biggest problem these days is whether to identify myself as being positive to potential partners. I have had it blow up in my face when I was honest and it hurts when people run away.

I met a guy on a mini-vacation and I was very interested in him. I didn't know I was already positive but by the time he came to the city I was living in to visit with the possible intention of a move, I had just found out my status and I told him at a club. He was very encouraging verbally but soon left. He never made an effort to keep in contact and avoided when I went back to his city for visits.

It really was the worse thing that could have happened so soon after my diagnosis because now I refrain from telling people immediately - however I do make sure not to put them in danger.

Some people we talked to admitted their fears of rejection ran deeper than telling people about their HIV: 'I wasn't very comfortable with myself. I never approached anybody… I was horrified at the thought of being rejected.' Some people who worked through their fears of rejection found they were better able to cope with rejection. One man became philosophical: 'If they want to know me that's all good and well, if they don't, then that is their loss is the way I look at it 20 years on.'

Because of the potential for rejection, people developed their own ways of telling potential partners (see also 'Sex and relationships'). For instance, some people put their HIV status on their profile on Internet dating sites. Others used a strategy of allowing potential partners time to get to know them before revealing their HIV status: 'I give them 10 minutes to like me. And when I start getting them laughing and joking, that's when I tell them,' said one man. But people were not always in the mood to be upfront about their HIV. One man said, 'Sometimes I would feel confident, and sometimes I wasn't confident.'